Tuesday, September 23, 2014

you can't give hugs in jail

First, some background: The LA County Jail is the largest jail system in the country (and possibly the world). It is made of up 9 different facilities that house 15,000-20,000 inmates at any given point in time. Men's Central Jail is one of these 9 facilities. It can house up to 5,000 inmates.It is located on the northeast edge of downtown Los Angeles. Five percent of the inmates in Men's Central Jail have known HIV. I work there 2 days each week providing HIV care.

To enter the jail wards, you have to go through a sallyport (aka cage) - where you enter through one gate, which closes behind you, then wait until the second gate opens into the ward. It's a little intimidating. I was given a couple pieces of advice for working in jail:1. Wear pants. (Pants as opposed to my usual dresses. Not pants as opposed to nothing.)2. If you get lost inside, don't wander. Just fall to the ground and start shaking. A security camera will eventually see you and send help. (I have yet to need this.)

One of my first patients was a young man who recently moved to LA (as always, details changed to protect privacy). He found out he had HIV a while ago but hadn't seen a doctor yet. Despite violence in his family growing up, he'd come far in life. He was credits away from bachelor's degree and had plans to open his own company. He was well-educated about HIV and what it meant when someone had progressed to AIDS. But that knowledge didn't prepare him for the fact that his infection had gone that far. So this beautiful boy, who I'd already invaded with personal questions and now broke crushing news to, started to cry. Because he hasn't lived a quarter of a century and already has AIDS. Because whatever hope led him to LA has been derailed by incarceration. Because his momma sits across the country and has no idea her son is in jail or that he has been living with HIV. In any other setting, I'd reach out and touch him - place a hand on his arm or pat his shoulder or offer a hug. But you can't give hugs in jail. So I willed my eyes to speak what I couldn't communicate with touch so he would know he is not alone. Over and over, I reassured him: this is not the end. things can get better. you can get better. He was released the next day. He knows where to find the clinic where I work. I hope he comes. I owe him a hug.